Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.96 / $62.21 / $96.06	Facility		$14.96	$62.21	$96.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $16.00 / $21.88	Professional		$14.00	$16.00	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.61 / $19.61 / $19.61	Facility		$19.61	$19.61	$19.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $19.92	Professional		$15.69	$15.69	$19.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.48 / $21.48 / $25.10	Facility		$21.48	$21.48	$25.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.72 / $15.82 / $22.61	Facility		$8.72	$15.82	$22.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $11.39 / $12.94	Professional		$10.31	$11.39	$12.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3.64 / $15.69 / $34.94	Facility		$3.64	$15.69	$34.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1.34 / $31.38 / $31.38	Professional		$1.34	$31.38	$31.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $3.64 / $15.69 / $75.29	Facility		$3.64	$15.69	$75.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $31.38	Professional		$15.69	$15.69	$31.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $65.00 / $85.00	Professional		$10.14	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3.64 / $15.69 / $34.94	Facility		$3.64	$15.69	$34.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1.34 / $31.38 / $31.38	Professional		$1.34	$31.38	$31.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.91 / $15.70 / $24.44	Professional		$7.91	$15.70	$24.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15.69 / $15.69 / $100.00	Facility		$15.69	$15.69	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $15.69	Professional		$15.69	$15.69	$15.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $15.69	Professional		$15.69	$15.69	$15.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5.07 / $22.03 / $22.03	Professional		$5.07	$22.03	$22.03
United Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $20.39	Professional		$15.69	$15.69	$20.39